CS000000-A | 07/07/21

COVID-19 State of Vaccine 

Confidence Insights Report

Report 11 | July 7, 2021 | Date Range: June 8 – 21, 2021

Summary

Findings. Consumers expressed concern about the Delta variant of the virus that causes COVID-19 potentially causing 

more severe illness. While this was a motivating factor for some consumers to get vaccinated, others felt the variants 

were a sign of the virus becoming endemic, decreasing the perceived importance of vaccination. As the United States 

continues to return to prepandemic-style life, some consumers expressed concern that employer- or education-based 

vaccination requirements and proof-of-vaccination systems to attend large events or travel infringed on their individual 

liberties. Consumers were divided, with some claiming that that those who are vaccinated do not need to worry 

about the vaccination status of others. Finally, concerns about myocarditis and pericarditis following mRNA COVID-19 

vaccination were widespread. More information about consumers’ perceptions and opinions regarding myocarditis and 

pericarditis following vaccination can be reviewed in the Rapid COVID-19 State of Vaccine Confidence Insights Report, 

released on June 29, 2021.

Ways to take action. Federal, state, and local partners should continue to work together to increase transparency 

around rationale for updated guidance, respond to gaps in information, and confront misinformation with evidencebased messaging. The goal of these efforts is to increase confidence in COVID-19 vaccines and expand vaccine uptake 

more broadly. Messages should be developed and disseminated to provide known information about the effectiveness 

of available COVID-19 vaccines against emerging variants, as well as the role vaccination plays in reducing the spread 

and emergence of new variant viruses. Policies regarding travel and large gatherings should be evaluated to identify 

opportunities to reduce requirements for fully vaccinated people that could motivate consumers within the moveable 

middle to get vaccinated.

Contents

2 Aims and Methods

3 Consumers confused and concerned about the 

effectiveness of currently available vaccines against the 

delta variant.

4 Some consumers feel that vaccine mandates and 

proof-of-vaccination systems infringe on individual 

liberties.

6 Continuing and Evolving Themes

7 Appendix

Centers for Disease Control & Prevention, 

COVID-19 Response, Vaccine Task Force

Vaccine Confidence & Demand Team, Insights Unit

The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC).
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COVID-19 State of Vaccine Confidence Insights Report | Report 11 | July 7, 2021

Aims and Methods

By rapidly reviewing and analyzing numerous sources and inputs (see Appendix), the biweekly COVID-19 State of Vaccine 

Confidence Insights Report emphasizes major themes that influence COVID-19 vaccine hesitancy and uptake. These are 

characterized by level and type of threat to vaccine confidence, degree of spread, and directionality. By examining how 

consumers think and feel, social processes, and the practical issues around vaccination, the Insights Report seeks to identify 

emerging issues of misinformation, disinformation, and places where intervention efforts can improve vaccine confidence 

across the United States.

The information in this report is only a snapshot, and certain populations may be underrepresented. Images and quotes are 

illustrative examples and are not meant to be comprehensive of all content related to the highlighted themes. 

Theme Classification

How do you classify this theme/information? 

High risk Moderate risk Low risk Positive sentiment

 May lead to vaccine

refusals and decreased

uptake

 Wide reach, pervasive

 Potential to trigger

hesitancy to vaccination

 Moderate reach, modest

dissemination

 Concerning, but low risk

to vaccine confidence

 Limited reach, limited

dissemination

 Could increase vaccine

confidence, intent, or

motivation

 Variable reach and

dissemination

How has this theme/idea changed over time (since last report or over the course of multiple reports)? 

Increasing

Information spreading rapidly 

Stable

Information remaining 

constant at prior level 

Decreasing

Information is not gaining further 

traction and there has been no 

indication of additional activity 
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COVID-19 State of Vaccine Confidence Insights Report | Report 11 | July 7, 2021

Major Themes

Consumers are confused and concerned about the effectiveness of currently 

available vaccines against the Delta variant.

News coverage of the Delta variant of the virus that causes COVID-19 steadily increased in June 2021. While coverage in early June 

focused mostly on cases in the United Kingdom and other countries across the globe,1,2,3 coverage of the Delta variant rapidly 

spreading in the United States became more prevalent towards the end of the reporting period.4,5,6Health authorities attempted 

to leverage the Delta variant as a motivator for people to get vaccinated by talking to news media outlets, with prominent leaders 

noting that vaccination is key to preventing the spread of the Delta variant in the United States.7,8Online searches for Delta variantrelated terms increased drastically,a

 but no webpage from a U.S. health authority commonly surfaced in the top 10 search results.b

Alongside the increase in news coverage and online searches, conversations among consumers also rose, with a 223% increase 

in mentions on social media during the reporting period.c Consumers 

expressed concern about the potential severity of Delta variant 

COVID-19 cases, especially for those who are unvaccinated.9,10Vaccinated 

consumers noted that they could still be vulnerable to the Delta 

variant,11,12 with some highlighting cases caused by the Delta variant 

among fully vaccinated people.13,14Consumer concerns were further 

fueled by news media and consumers posting a wide range of estimates 

about the effectiveness of currently available vaccines against the 

Delta variant,15,16,17,18 leading to some people asking if they should be 

re-vaccinated with a different vaccine.19,dAmong consumers wanting to 

”wait and see” before getting vaccinated, 6 in 10 indicated that they were 

very or somewhat worried about the effectiveness of currently available vaccines against variants, according to one recent poll.20

Some consumers indicated that they would not seek vaccination, as they perceived the Delta variant as evidence that the virus is 

becoming endemic like influenza virus.21,22,23

These concerns about vaccine effectiveness against variant viruses led some consumers to wonder if and when booster doses 

would be needed, and if they received Johnson & Johnson’s Janssen COVID-19 Vaccine, whether they needed a dose of an mRNA 

vaccine.24,25,26 The concerns caused some to ask if mitigation measures previously removed for fully vaccinated people should be 

reinstated to slow the spread of the Delta variant 27,28,29,30 and made some feel like the United States may never return to normal.31

News coverage and consumer conversations focused on the potential for the spread of the Delta variant to outpace vaccination 

coverage.32,33At the same time, vocal vaccine deniers claimed that vaccines themselves have allowed variants to spread and that 

vaccination could actually reduce the immune system’s ability to fight off infection.34,35 They also claimed that natural immunity 

from previously having COVID-19 or that getting COVID-19 if not already naturally immune is safer than getting vaccinated.36,37,38

Ways to act:

 Expand web content and create clear, consistent messaging about the effectiveness of COVID-19 vaccines against variants of

concern. Communicate often about what is known and unknown about the Delta variant and other variants of concern and

about the effectiveness of currently available vaccines.

 Develop and disseminate messaging about how to protect people who cannot be vaccinated, especially children less than 12

years old and people with compromised immune systems.

 Develop and disseminate messages about how variant viruses evolve and the role that vaccination plays in slowing the spread

and emergence of new variants. Provide guidance and talking points to healthcare professionals to discuss this topic with

their patients to motivate them to get vaccinated.

aGoogle Trends

b SEMrush

c Meltwater

d CDC-INFO
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COVID-19 State of Vaccine Confidence Insights Report | Report 11 | July 7, 2021

Some consumers feel that vaccine mandates and proof-of-vaccination systems 

infringe on individual liberties.

Tension continues between vaccinated and unvaccinated consumers regarding vaccine mandates and proof-of-vaccination 

systems. Several legislative actions were taken during the reporting period to prohibit or ban mask, testing, or vaccination 

mandates for employers and businesses, as well as within the education sector.39,40,41,42,43,44,45 However, reports of employers 

requiring vaccination, particularly in the healthcare and travel industries, continue to emerge,46,47 with one high-profile lawsuit 

against a vaccine requirement being dismissed in court.48 These reports caused some consumers to wonder about the legality of 

employers requiring vaccination49 and whether employers and businesses could request that people disclose their vaccination 

status,50,51 with online searches for “vaccine mandate” increasing by 22% between May and June 2021.e

 Public opinion seems 

split on the issue. One poll of 1,027 people found that 52% of respondents supported requiring COVID-19 vaccination in 

the workplace.52 Another poll of 500 people found that the majority of respondents believed that employers had the right 

to request proof of vaccination, but they did not think employers should be able to fire employees if they opted not to get 

vaccinated.53 The presence and absence of vaccine mandates within education settings has also become a point of contention. 

Reports of protests and class-action lawsuits against vaccine mandates in education settings surfaced54,55,56,57 alongside calls for 

institutions to reverse their stance on not requiring vaccination58,59 or lauding the decision to require vaccination for all students 

and employees.60

Vaccine requirements for travel or to attend large events 

continue to be some of the top remaining motivators for 

people wanting to “wait and see” before getting vaccinated 

according to one poll.61 News coverage increased about how 

vaccination status is used in different settings to publicly 

identify and deny access to people who are unvaccinated or 

cannot produce a recent negative COVID-19 test.62,63,64 Some 

pro-vaccine consumers felt policies requiring vaccination or 

disclosure of vaccination status would not be feasible nationally 

without a standard proof-of-vaccination system.65,66 However, 

other consumers expressed concerns that proof-of-vaccination 

systems were a means to “segregate” people and were a violation 

of privacy.67,68,69 One poll of 868 people reported that a slim 

majority (55%) of respondents felt that unvaccinated and 

vaccinated people should have the same rights.70 This aligned 

with consumer comments online stating that people who are 

vaccinated should not care about the vaccination status of 

others71,72 and that unvaccinated people are only a danger to 

themselves.73 Further, more than half of people who identified as 

unvaccinated in one recent poll reported feeling that additional people do not need to be vaccinated because the rate of new 

COVID-19 cases is low.74

Ways to act:

 Continue to disseminate messages about the benefits of vaccination, including how vaccination protects the person who

is vaccinated as well as others around them. Consider highlighting case data comparing the number of current cases of

COVID-19 among unvaccinated and vaccinated people.

 Evaluate policies related to travel and large gatherings for vaccinated individuals. Where possible, consider allowing

individuals with proof of being fully vaccinated to forgo testing, masking, or quarantine requirements to help motivate

vaccination intent among those who are not yet vaccinated.

e SEMrush
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COVID-19 State of Vaccine Confidence Insights Report | Report 11 | July 7, 2021

Continuing and Evolving Themes

Themes below have been noted in previous reports and continue to undermine vaccine confidence. The information 

highlighted below focuses on what is new or different from previous reports. For additional context and previous 

recommendations on these themes see previous Insights Reports.

 Adverse events. Claims that COVID-19 vaccines have caused

a large number of deaths continue to be reported by

some news outlets and amplified by vocal vaccine deniers 

using data from Vaccine Adverse Event Reporting System 

(VAERS) as evidence.75,76 Some consumers continued to 

amplify these claims of “mass death” following vaccination 

throughout social media.77,78,79,80 

New ways to act: 

 Continue to develop and disseminate messages about 

what VAERS is and how it works. Include messaging about 

what is known about the incidence rate of adverse events 

and highlight how many doses of vaccine have been safely administered to people across the United States. 

 Concerns from people with compromised immune systems. A new study by Johns Hopkins looking at vaccine

effectiveness in transplant patients found that a third dose of vaccine can boost protection against COVID-19.81,82 This has 

caused some immunocompromised consumers to seek guidance regarding whether they should get a third dose, and if so

what the timing would be.83,84,85

 Origin of virus that causes COVID-19. News reports increased on a new analysis that found that “rare and sporadic cases” 

were likely in the United States as early as December 2019,86,87 giving further credence to the belief held by many consumers

that the virus was made in a laboratory and could have been released intentionally.88,89,90
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COVID-19 State of Vaccine Confidence Insights Report | Report 11 | July 7, 2021

Appendix: Inputs and Sources

Type Input Cadence Sources Tactics for Utilization

Social 

Media 

Listening 

& Media 

Monitoring

Communication Surveillance 

Report

Daily on 

weekdays

Google news

 Meltwater

CrowdTangle

Native platform searches

 Share of voice topic analysis to identify themes

 Emerging topics 

Meltwater Daily  Facebook, Twitter, Instagram

 Blogs

News media

Online forums

 Share of voice topic analysis

 Emerging theme topics

Identify high reach/velocity topics

OADC Channel COVID-19 Post 

metrics

Weekly  Sprout Social

Native OADC account analytics

 Analyze # of posts, topics 

 Success of messages, # of impressions, reach, # 

engagements

OADC Channel Comment 

Analysis

Daily on 

weekdays

Native platform searches  Sentiment analysis

Identify message gaps/voids

Direct 

Reports

CDC-INFO Metrics Weekly CDC-INFO inquiry line list

 Prepared response (PR) usage 

report

 Cross-compare PR usage with inquiry theme 

analysis

 Sentiment analysis

Identify information gaps/voids

VTF Media Requests Weekly  Media request line list  Leading indicator for news coverage

Identify information gaps/voids

Web Metrics Weekly  Top pages

Google search queries

 Top FAQs

 Referring domains

Identify information gaps/voids,

Identify keywords/search terms, changes in 

web traffic

Research

Poll Review Weekly Harris Poll, PEW research, Gallup 

Poll, KFF 

New data related to vaccine 

hesitancy

Identify socio-behavior indicators related to 

motivation and intention to vaccinate 

Literature Review Weekly  PubMed, LitCovid, ProQuest 

Central 

New data related to vaccine 

hesitancy

Identify current vaccination intention

Identify barriers to vaccination

Third Party 

Reports

Tanaq Social Listening +Media 

Monitoring Report

Weekly  Meltwater

 Sprout Social

 First Draft

Native platform searches

 Trending topics

Demographic and geographic conversation 

monitoring

CrowdTangle content insights 

report

Biweekly  Facebook  Top pages (voices), groups

General trends/sentiment analysis

News analysis through posts

FEMA Social Listening Report Daily Hootsuite

 Brandwatch

CrowdTangle

 Meltwater

 Trends/sentiment analysis

National and global news analysis

First Draft News Vaccine 

Misinformation Insights 

Report

Monthly  Proprietary methods  Media trends analysis

 Emerging threats and data deficits

Online vaccine narratives

Project VCTR Weekly  Proprietary methods National and regional trends in negative 

attitudes toward vaccination

Conversations around Legislation

Virality Project Weekly  Proprietary methods  Mis- and disinformation trends related to 

COVID-19 vaccine